Virginia Cardiovascular Group, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

0101237500 Issued in VA

Legal business name

VIRGINIA CARDIOVASCULAR GROUP, LLC

Practice address

19450 Deerfield Ave
Ste 335
Leesburg, VA 20176-6820

Phone

(703) 939-9942

NPI assigned

Jul 7, 2014

Last updated

Jul 7, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tarek Abou Ghazala, MDNPI 1609867381

Title

President

Phone

(703) 939-9942

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tarek Abou-Ghazala, M.D.

  • Cardiovascular Disease Physician
  • Reston, VA
  • NPI 1609867381

  DC

  Medicare reassignment Authorized official
• Walid Mohamed Hassan, MD

  • Cardiovascular Disease Physician
  • Honesdale, PA
  • NPI 1275857310

  DC

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1982010302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVE",
            "address_2": "STE 335",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVE",
            "address_2": "STE 335",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766820",
            "telephone_number": "703-939-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA CARDIOVASCULAR GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "ABOU GHAZALA",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-939-9942",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "VA",
            "license": "0101237500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Medical Specialty Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.